Vitamin D Supplements Reduce Pain in Fibromyalgia Sufferers

Researchers say vitamin D may be cost-effective treatment or adjunct for patients with fibromyalgia syndrome and low vitamin D Levels, reports PAIN®

Philadelphia, PA, January 17, 2014

Patients with fibromyalgia syndrome (FMS) typically have widespread chronic pain and fatigue. For those with low vitamin D levels, vitamin D supplements can reduce pain and may be a cost-effective alternative or adjunct to other treatment, say researchers in the current issue of PAIN®.

In addition to pain and fatigue, individuals diagnosed with FMS may experience sleep disorders, morning stiffness, poor concentration, and occasionally mild-to-severe mental symptoms such as anxiety or depression. The condition can have a significant impact on the patient's quality of life, resulting in loss of employment and/or withdrawal from social life. There is no cure, and no treatment will address all of the symptoms, but some symptoms may be alleviated by physical therapy, cognitive behavioral therapy, temporary drug therapy (such as amitriptyline, duloxetine, or pregabaline) and multimodal therapies.

Calcifediol (also known as calcidiol, 25-hydroxycholecalciferol, or 25-hydroxyvitamin D (OH)D) is a prehormone produced in the liver by the enzyme cholecalciferol (vitamin D3). Calcifediol is then converted to calcitriol (1,25-(OH)2D3), which is the active form of vitamin D. The concentration of calcifediol in blood is considered the best indicator of vitamin D status.

Researchers hypothesized that vitamin D supplementation would reduce the degree of chronic pain experienced by FMS patients with low levels of calcifediol and also might improve other symptoms. “Low blood levels of calcifediol are especially common in patients with severe pain and fibromyalgia. But although the role of calcifediol in the perception of chronic pain is a widely discussed subject, we lack clear evidence of the role of vitamin D supplementation in fibromyalgia patients,” says lead investigator Florian Wepner, MD, of the Department of Orthopaedic Pain Management, Spine Unit, Orthopaedic Hospital, Speising, Vienna, Austria. “We therefore set out to determine whether raising the calcifediol levels in these patients would alleviate pain and cause a general improvement in concomitant disorders.”

In a randomized controlled trial, 30 women with FMS with low serum calcifediol levels (below 32ng/ml) were randomized to a treatment or control group. The goal for the treatment group was to achieve serum calcifediol levels between 32 and 48ng/ml for 20 weeks via oral cholecalciferol supplements. Serum calcifediol levels were reevaluated after five and 13 weeks, and the dose was reviewed based on the results. The calcifediol levels were measured again 25 weeks after the start of the supplementation, at which time treatment was discontinued, and after a further 24 weeks without supplementation.

Twenty-four weeks after supplementation was stopped, a marked reduction in the level of perceived pain occurred in the treatment group. Between the first and the 25th week on supplementation, the treatment group improved significantly on a scale of physical role functioning, while the placebo group remained unchanged. The treatment group also scored significantly better on a Fibromalgia Impact Questionnaire (FIQ) on the question of “morning fatigue.” However, there were no significant alterations in depression or anxiety symptoms.

“We believe that the data presented in the present study are promising. FMS is a very extensive symptom complex that cannot be explained by a vitamin D deficiency alone. However, vitamin D supplementation may be regarded as a relatively safe and economical treatment for FMS patients and an extremely cost-effective alternative or adjunct to expensive pharmacological treatment as well as physical, behavioral, and multimodal therapies,” says Wepner. “Vitamin D levels should be monitored regularly in FMS patients, especially in the winter season, and raised appropriately.”

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Notes for editors
“Effects of vitamin D on patients with fibromyalgia syndrome: A randomized placebo-controlled trial,” by Florian Wepner; Raphael Scheuer; Birgit Wieser; Peter Machacek; Elisabeth Pieler-Bruha; Heide S Cross; Julia Hahne; Martin Friedrich (DOI: http://dx.doi.org/10.1016/j.pain.2013.10.002). It appears in PAIN®, Volume 155, Issue 2 (February 2014) published by Elsevier.

Full text of the article is available to credentialed journalists upon request. Contact Terry Materese at +1 215 239 3196 or painmedia@elsevier.com for copies. Journalists wishing to interview the authors should contact Dr. Florian Wepner, Orthopaedic Hospital Vienna, Speising, at +43 1 80182 1796, +43 699 1945 2134 (mobile) or Florian.Wepner@bhs.at.

About PAIN®
PAIN®, the official journal of the International Association for the Study of Pain® (IASP®), publishes 12 issues per year of original research on the nature, mechanisms, and treatment of pain. This peer-reviewed journal provides a forum for the dissemination of research in the basic and clinical sciences of multidisciplinary interest and is cited in Current Contents and MEDLINE. It continues to be ranked No.1 out of the 29 journals in the Anesthesiology category, according to the 2012 Journal Citation Reports, published by Thomson Reuters. www.painjournalonline.com

About the International Association for the Study of PAIN® (IASP®)
IASP® is the world's largest multidisciplinary organization focused specifically on pain research and treatment. It is the leading professional forum for science, practice, and education in the field of pain, bringing together scientists, clinicians, health-care providers, and policymakers to stimulate and support the study of pain and to translate that knowledge into improved pain relief worldwide. Founded in 1973, IASP has nearly 8,000 members from 133 countries and in 90 chapters. www.iasp-pain.org

About Elsevier

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Media contact
Terry Materese
+1 215 239 3196
+1 215 327 9934
painmedia@elsevier.com